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The effect of virtual reality physiotherapy on brain function in multiple sclerosis
Raková, Michaela ; Řasová, Kamila (advisor) ; Kővári, Martina (referee)
Introduction This study investigated the changes in brain activity on functional magnetic resonance imaging (fMRI) in individuals with multiple sclerosis who underwent virtual reality (VR) physiotherapy. Specifically, the brain and its functions, which are damaged by this disease, are the ones we want to affect most by the therapy. However, we currently do not have studies that address this topic and investigate the direct effect of physiotherapy on brain function. This study investigated whether there can be observable changes in brain activity due to therapy. To find whether these activations may be different in the experimental group than in the control group. The question was also whether the results from fMRI could correlate with the results of clinical tests. Methods Subjects were randomly divided into two intervention groups. Both groups underwent the same neurophysiological-based physiotherapy, the experimental group in a virtual reality environment, while the control group in a standard environment. Proprioceptive Neuromuscular Facilitation and Motor Program Activating Therapy programs were used. Each proband was examined before and after the therapy sessions with clinical tests (Nine Hole Peg Test (NHPT), Box and Block Test and dynamometer examination) and fMRI. The fMRI recorded motor...
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Rehabilitation influence on quality of life in neurological patients
Kövári, Martina ; Kobesová, Alena (advisor) ; Kubala Havrdová, Eva (referee) ; Angerová, Yvona (referee)
Rehabilitation influence on quality of life in neurological patients Abstract: This work focuses on neurorehabilitation procedures that influence disability and improve the quality of life of neurological patients, especially those with multiple sclerosis (MS). We identified several positive effects of a complex physiotherapy program based on optimal postural stabilization training, intra-abdominal pressure regulation, and pelvic floor activation with biofeedback on anorectal dysfunction in MS patients. Fecal incontinence and subjective discomfort measured by St. Mark's Incontinence Score Questionnaire significantly decreased after the rehabilitation program with a physiotherapist. Changes in anorectal pressures after the rehabilitation program were not statistically significant, but a positive trend was found in the ability to activate the anal sphincter and pelvic floor muscles. The MS patients also regularly performed Pilates exercises. Significant improvements in gait speed and endurance, even during dual tasking situations, i.e. when walking and performing cognitive tasks were identified. Pilates exercise also significantly improved balance measured by the MiniBEST test and by the Falls Efficacy Scale International Questionnaire. The immediate effect of electrical stimulation according to Jantsch...
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Telerehabilitation in patients with multiple sclerosis
Zeiselová, Jitka ; Novotná, Klára (advisor) ; Kövári, Martina (referee)
The subject of this master thesis is telerehabilitation in pacients with multiple sclerosis with a focus on patients with higher neurological deficit. Multiple sclerosis is a chronic degenerative disease affecting the central nervous system. According to the latest information (31.12.2021) from the ReMuS register there is 17 148 patients with a multiple sclerosis in the Czech republic. Altogether 71 % from this amount are women. The aim of this thesis is breifly introduce the topic of multiple sclerosis, its etiopathogenesis, diagnostic, symptomatology and therapy, with a focus on rehabilitation. Next chapter of the theoretical part is dedicated to telemedicine. There are information about history of telemedicine, some possibilities of its use in other fields of rehabilitation and also describes some platforms which can be used for providing an online therapy. Practical part of the thesis consists of two sections. The first one contains a survey which investigates amount of awareness of telerehabilitation and also amount of interest of it in patients with multiple sclerosis, partially for the needs of the Saint Joseph's Home which plans to expand its rehabilitation services. In the second part we wanted to prove the feasibility of telerehabilitation in patients with higher neurological deficit...
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Physical activity in patients with MS: Effect of coronavirus pandemic on physical activity and rehabilitation
Šulcová, Anna ; Novotná, Klára (advisor) ; Kövári, Martina (referee)
The bachelor thesis deals with the impact of the Covid-19 epidemic on patients with multiple sclerosis, mainly focusing on the impact on their physical activity. The aim of the thesis is to investigate whether and how people with MS changed their physical activity during the epidemic. Furthermore, it was investigated whether the choice of activity and the intensity and frequency of activity changed. A part of the questions dealt with the fears of the disease Covid-19. The theoretical part summarizes the basic knowledge about the diagnosis, and more focuses on the rehabilitation and physical activity of the patients. The practical part deals with the results obtained through the questionnaire survey. The questionnaire was carried out within the framework of an international study sponsored by the international professional society RIMS (Rehabilitation In Multiple Sclerosis). Several European countries, including the Czech Republic, participated in the study. Due to the epidemic, the questionnaire was distributed online and responses were collected from December 2020 to June 2021. The research sample consisted of 265 people. The data are presented in the form of tables and graphs. The results showed that 233 patients engaged in some physical activity prior to Covid-19. In the context of the epidemic,...
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Influence of Botulinum Toxin Application on Quality of Life in Patients with Multiple Sclerosis
Miňová, Zuzana ; Jirásková, Lucie (advisor) ; Kövári, Martina (referee)
The aim of the bachelor's thesis is to find out how medical application of botulinum toxin can affect the quality of life in patients with multiple sclerosis. The thesis is based on theoretical research providing a brief overview of the basic facts about multiple sclerosis - its pathogenesis, etiology, clinical picture, treatment alternatives. Further on, the thesis deals with the concept of spasticity, possibilities to influence it and also its valuation. The subsequent section comprises an overview of the findings about botulinum toxin and its therapeutic application. The term quality of life, an influence of the disease on the quality of life and also the methods used to evaluate it are described at the end of the theoretical part. The practical section contains case histories of two patients who underwent the medical application of botulinum toxin. The thesis is closed by a discussion on this topic. Powered by TCPDF (www.tcpdf.org)
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The effect of facilitation physiotherapy on cognitive functions in multiple sclerosis patients
Kořínková, Markéta ; Řasová, Kamila (advisor) ; Kövári, Martina (referee)
Cognitive function disorders have an enormous impact on the life quality of a patient, his or her family and close people. It influences the patient's job, social interaction and independence. This diploma thesis focuses on the possibility of improving cognitive functions concerning multiple sclerosis with the help of facilitation physiotherapy. Twelve disordered volunteers participated a two-month physiotherapeutic programme (motor programs activating therapy), for 1 hour, twice per week. Before the beginning and after the end of the therapeutic programme an examination by a clinic test PASAT and the monitoring of functional magnetic resonance was done. The results of functional magnetic resonance were further compared with the results of group of healthy volunteers. Concerning clinic test, the results of the disordered patients have improved after the therapy. In functional magnetic resonance statistics the earlier start and change of a curve progress of brain activation was discovered, which portrays improving speed of processing information at multiple sclerosis disordered.
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Anorectal dysfunction in multiple sclerosis
Motlová, Alžběta ; Kövári, Martina (advisor) ; Bitnar, Petr (referee)
This thesis is interested in summary of anorectal dysfunction in patients with sclerosis multiplex. This thesis is divided into 2 parts. The objective of the first part is a description of the anorectal dysfuntions. It also includes epidemiological data, dividing, investigating algorithms and possibilities of therapy. The second part is consisting of the case report of pacient with fecal incontinence who underwent the physiotherapy. Her medical history, individual therapy according to kinesiological analysis, evaluation by rectoanal manometry and subjective questionnaire are widely described within. Therapy is assessed by standardised questionnaire Fecal Incontinence Quality of Life Scale and St. Marks Continence Scale. The anorectal manometry evaluates the function of anal sphincters while at rest, during a voluntary contraction and also subcribes sensitivity of rectum. The subjective questionnaires reflect the psychosocial aspects and patient's quality of life. The analysis of fuction and kinesiological analysis were performed before and after physiotherapy and then after 3 months of hometherapy.
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Methods of a grip evaluation after reconstructive surgery of the spastic hand
Pechová, Petra ; Fialová, Ludmila (advisor) ; Kövári, Martina (referee)
The aim of the thesis was to find out which areas of life of people with hand spasticity may affect the performance of reconstructive surgery. Furthermore, to determine which specific factors involved in the function and dysfunction of the upper limb in people with upper motor neuron syndrome can affect the results of the intervention, and what are the relationships between these factors. The group consisted of 13 people with cerebral type of spasticity. Subjects were examined preoperatively, three months after the intervention, and five months after the intervention. Operations were performed in the wrist-hand and elbow region. Subjects were examined repeatedly by some sensory modality, goniometry, Frenchay arm test, Score for visual evaluation of functional task of the hand, The QuickDASH, modified Ashworth Scale, modified Barthel Index and each person was classified according to The Manual Ability Classification System. There was an elbow contracture release and an improvement in an active motion in the wrist as result of the intervention. The results showed a statistically significant difference in some test scores Frenchay arm test, Score for visual evaluation of functional task of the hand, The QuickDASH and the modified Barthel Index before and after intervention. In a group of people with...
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Influence of spasticity in patients with multiple sclerosis using method of electrical stimulation according to Jantsch
Pokorná, Anna ; Kövári, Martina (advisor) ; Kříž, Jiří (referee)
The electrical stimulation (ES) according to Jantsch was created with a primary aim to reduce spasticity, however its impact has been neither proved nor disproved by any study. Therefore, the aim of the thesis is to find out if this type of the ES can reduce spasticity of m. triceps surae within the patients with multiple sclerosis (MS). Apart from the spasticity, there was as well observed the influence of the ES on an active movement performed by the antagonists of spastic muscle and the walking speed. Fifteen probands participated in our pilot controlled non- randomized study, probands were divided into two groups - first with the application of the ES (STIM) and second without the application of the ES (NOSTIM) during the hospitalization. We used the concept of Jean-Michel Graciese - Five-step clinical assessment in spastic paresis during the examination process. From this protocol, we choose Tardieu scale to measure spasticity, examination to measure active range of motion and 10MWT. Furthermore, TUG was added. The measurements took place on the 1st, 4th and 8th day of the hospitalization. The intragroup difference was evaluated by the ANOVA for repetitive measures with Fisher's post- hoc test and the level of importance p=0.05. From acquired data it follows that the ES according to Jantsch...
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